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wo Knitting Needles in the Thorax in a Suicidettempt Diagnosed on Day 6 and Treatedonservatively

icolas Peschanski, MD, Christophe Clamageran, MD, Nicole Dardel, MD,quilina Vianney, MD, and Frédéric Lapostolle, MD, PhD

ervice d’Aide Médicale d’Urgence 76A SAMU, Hôpital Charles Nicolle, Centre Hospitalier Universitaire-Hôpitaux de Rouen,

ouen Cedex; and Service d’Aide Médicale d’Urgence 93 SAMU, Hôpital Avicenne, Bobigny, France

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e report the case of a 27-year-old man admitted toa psychiatric unit for management of severe de-

ression. This patient was referred to our emergencyepartment after a reported suicide attempt 6 days ear-

ier, the patient having supposedly inserted 2 knittingeedles in his chest.The physical examination discovered 2 punctiform and

nflammatory wounds in the fourth and fifth intercostalpaces, under the left nipple. The patient did not showny signs of hemodynamic or respiratory compromise.he electrocardiogram result was also normal. Chest

ddress correspondence to Dr Lapostolle, SAMU 93, Hôpital Avicenne, 125,ue de Stalingrad, 93009 Bobigny, France; e-mail: frederic.lapostolle@

Fig 1.

rvc.aphp.fr.

2011 by The Society of Thoracic Surgeonsublished by Elsevier Inc

oentgenogram (Fig 1, top panels) and computed tomog-aphy scan (Fig, bottom panels) revealed two 27-cmnitting needles, the first (arrow 1) penetrating the leftentricle, and the second was in the pericardium, in frontf the anterior wall of the left ventricle.The patient was transferred to a hospital with cardiac

urgery facilities. He was observed for 8 days; however,o surgical intervention was performed and the needlesere left in the chest. Evolution was uneventful and theatient was discharged to a psychiatric unit. At the 1-year

ollow-up, results of electrocardiogram, echocardiogra-hy, and computed tomography scan were normal. Nodverse event related to the needle presence was

eported.

Ann Thorac Surg 2011;91:305 • 0003-4975/$36.00doi:10.1016/j.athoracsur.2010.05.062